Individual
MARY C BURRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
322 OLD STATE RD, ELLISVILLE, MO 63021-5917
(636) 449-1674
Mailing address
6 LANTANA CT, SAINT PETERS, MO 63376-5304
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2001011308
MO
Other
Enumeration date
07/12/2007
Last updated
07/12/2007
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